Healthcare Provider Details

I. General information

NPI: 1457151995
Provider Name (Legal Business Name): GRASE SPEAK LIFE SPEECH THERAPY & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5833 POPLAR HALL DR
NORFOLK VA
23502-3815
US

IV. Provider business mailing address

2 PATRIOT CRES
HAMPTON VA
23666-2815
US

V. Phone/Fax

Practice location:
  • Phone: 757-775-7479
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: TYRONECIA GRASE
Title or Position: OWNER
Credential:
Phone: 901-220-4094